A preliminary study has found that clinicial staff spend significantly less time with ICU patients at the end of their rounds, compared with the beginning of the rounds.

The study showed that the time decreased by a minute per patient in a 12 bed cardiothoracic ICU. Jones and colleagues found that rounds "did not adhere to a particular format, schedule, or structure. The order of patient visits varied substantially during the 20 days of observation, following a certain bed order on some days (clockwise or counterclockwise) and reflecting staff or attending-physician preferences on others."

Re: Do you spend less time on patients at the end of your ward rounds?

Due to some complex cases here and there, this will inevitably occur from time to time, specially with time constrains of the medical workload. Making a habit of it shows poor time keeping, poor patient management and may impact on the treatment of patients.

Re: Do you spend less time on patients at the end of your ward rounds?

Interesting discussion.It always seems that the patient at the end of the receiving round is the sickest person admitted that day, but perhaps that's because we always do the side rooms last?I try to start at a different point on the ward round each day, so sometimes I start in bay 1 and move around in the 'standard' way. Other times I start in the side rooms, and work backwards. Otherwise patients in bay 4 get to wait a long time to see the doctors.....Whether waiting extra time leads to a worse outcome, I don't think we can say. It smells like a registrar project to me!

Re: Do you spend less time on patients at the end of your ward rounds?

sometimes, depends on the day of the week, number of patients, other commttments after the round(meetings, clinic...); the way to go through this is to start the round from a different direction every day....

Re: Do you spend less time on patients at the end of your ward rounds?

I don't know about ICU, but in a mathematical modelling exercise we did on a course recently it was clear that the only parameter that influenced bed satate and waiting times for admission was discharging patients. It was commented that the best thing for the hospital as a whole would be for clinicians always to start with those who had been in longest rather than those just admitted (and therefore sicker) - counter to what most docotrs would like to do!

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